COURSE IN FORENSIC ODONTOLOGY

COURSE IN FORENSIC ODONTOLOGY

Forensic is derived from the Latin word forum, which means ‘court of law.' Odontology literally implies ‘the study of teeth.' Forensic odontology, therefore, has been defined by the Fédération Dentaire International (FDI) as "that branch of dentistry which, in the interest of justice, deals with the proper handling and examination of dental evidence, and with the proper evaluation and presentation of dental findings."

Objectives of the undergraduate curriculum
At the end of the programme, the dental graduate should:

1.

Have sound knowledge of the theoretical and practical aspects of forensic odontology.
2.

Have an awareness of ethical obligations and legal responsibilities in routine practice and forensic casework.
3.

Be competent to recognise forensic cases with dental applications when consulted by the police, forensic pathologists, lawyers and associated professionals.
4.

Be competent in proper collection of dental evidence related to cases of identification, ethnic and sex differentiation, age estimation and bite marks.
5.

Be able to assist in analysis, evaluation, and presentation of dental facts within the realm of law.

Curriculum for forensic odontology

1. Introduction to forensic dentistry
- Definition and history
- Recent developments and future trends

2. Overview of forensic medicine and toxicology
- Cause of death and postmortem changes
- Toxicological manifestations in teeth and oral tissues

3. Dental identification
Definition
- Basis for dental identification
- Postmortem procedures
- Dental record compilation and interpretation
- Comparison of data, and principles of report writing
- Identification in disasters and handling incinerated remains
- Postmortem changes to oral structures

4. Maintaining dental records
- Basic aspects of good record-keeping
- Different types of dental records

Dental charts
Dental radiographs
Study casts
Denture marking
Photographs
- Dental notations
- Relevance of dental records in forensic investigation

5. Age estimation
-Age estimation in children and adolescents

Advantages of tooth calcification over ‘eruption' in estimating age
Radiographic methods of Schour & Massler, Demirjian et al
- Age estimation in adults

Histological methods - Gustafson's six variables and Johanson's modification, Bang & Ramm's dentine translucency
Radiographic method of Kvaal et al
- Principles of report writing

6. Sex differentiation
Sexual dimorphism in tooth dimensions (Odontometrics)

7. Ethnic variations (‘racial' differences) in tooth morphology
Description of human population groups
Genetic and environmental influences on tooth morphology
Description of metric and non-metric dental features used in ethnic differentiation

8. Bite mark procedures
Definition and classification
Basis for bite mark investigation
Bite mark appearance
Macroscopic and microscopic ageing of bite marks
Evidence collection from the victim and suspect of bite mark
Analysis and comparison
Principles of report writing
Animal bite investigation

9. Dental DNA methods
- Importance of dental DNA evidence in forensic investigations
- Types of DNA and dental DNA isolation procedures
- DNA analysis in personal identification
- Gene-linked sex dimorphism
- Population genetics

10. Jurisprudence and ethics
- Fundamentals of law and the constitution
- Medical legislation and statutes (Dental and Medical Council Acts, etc)
- Basics of civil law (including torts, contracts and consumer protection act)
- Criminal and civil procedure code (including expert witness requirement)
- Assessment and quantification of dental injuries in courts of law
- Medical negligence and liability
- Informed consent and confidentiality
- Rights and duties of doctors and patients
- Medical and dental ethics (as per Dentists' Act)

THEORY SESSIONS AND PRACTICAL EXERCISES
Total hours for the course
- Didactic - 10-12 hours
- Practical - 20-25 hours

Detailed didactic sessions for the above components, either in the form of lectures or as structured student-teacher interactions, is essential. Specialists from multiple disciplines, particularly from legal and forensic sciences, can be encouraged to undertake teaching in their area of expertise.

An interactive, navigable and non-linear (INN) model may also be utilised for education.

Practical exercises (real-life casework and/or simulated cases) must complement didactic sessions to facilitate optimal student understanding of the subject. Mandatory practical training in dental identification methods, dental profiling (ethnic and sex differences, radiographic age estimation), and bite mark procedures, is of paramount importance. In addition, practical exercises/demonstrations in histological age estimation, comparative dental anatomy, DNA methods, medical autopsy, court visits, and other topics may be conducted depending on available expertise, equipment and feasibility.

Approach to teaching forensic odontology

Forensic odontology could be covered in two separate streams. The divisions include a preclinical stream and a clinical stream.

Preclinical stream
- Introduction to forensic odontology
- Sex differences in odontometrics
- Ethnic variations in tooth morphology
- Histological age estimation
- Dental DNA methods
- Bite marks procedures
- Overview of forensic medicine and toxicology

- It could prove useful to undertake the preclinical stream in II or III year under Oral Biology/Oral Pathology since these aspects of forensic odontology require grounding in dental morphology, dental histology and basic sciences, which, students would have obtained in I and/or II BDS.

Clinical stream
- Dental identification
- Maintaining dental records
- Radiographic age estimation
- Medical jurisprudence and ethics

It would be suitable to undertake these topics in the IV or V year as part of Oral Meicine and Radiology, since students require reasonable clinical exposure and acumen to interpret dental records, perform dental postmortems and analyse dental radiographs for age estimation.